3 Year Pilot EMS Recertification Program

Administrative Manual

Renewal of EMS Certification through Continuing Education

Table of Contents

October 2004 Updates

3-Year Pilot EMS Recertification Program Administrative Manual underwent a revision in October 2004. Due to a computer glitch, the "Revised 10/2003" edition of the Administrative Manual was printed with some errors. These errors have been corrected. The "10/2004" edition contains the corrections listed below (in bold highlights), and contains the most current forms (dated 7/03) used in the CME Pilot Recert Program. Otherwise, both the "10/2003" and the "10/2004" editions are the same.

Page 1 Table of Contents

  • Administrative Program Participant Form
  • Who should I contact if I have questions?
  • Approved program forms (effective 7/1/03)

Page 5 How does an Agency apply?

  • Agencies interested in participating in the Pilot Recertification Program need to file an "Agency Registration Form" (DOH-4227).

Page 7 What does a participant have to do to renew their certification?

  • To renew certification, an EMT/AEMT must complete at least 72 hours of "appropriate continuing education" that includes:
    1. Refresher Training (review of core content)
    2. CPR Certification
    3. ACLS Certification for paramedics
    4. Additional EMS related continuing education
    5. Verification of skill maintenance

Page 8 What are the different continuing education requirements for each provider level?

  • EMT-Intermediate
    • 34 hours of Refresher Training (review of core content)

Page 10 What type of continuing education is accepted?

  • A CIC who teaches an original or recertification course can claim the maximum hours for the "core content" area only.

Page 13 Instructors (CLI and CIC)

  • You must obtain an 85% or greater on the written exam for instructor certification.

What is the Pilot Recertification Program?

The Pilot Recertification Program allows an EMT, EMT-Intermediate, EMT-Critical Care or Paramedic, who is in continuous practice, demonstrates competency and completes appropriate continuing education, to renew their certification without taking a certification exam.

On August 17, 2001, Governor Pataki signed into law Chapter 190 of the Laws of 2001. This extended the law calling for the Commissioner of Health to develop a pilot program in at least six regions to allow an EMT/AEMT who is in "continuous practice," who has "demonstrated competence in applicable behavioral and performance objectives," and who has "demonstrated completion of appropriate continuing education," to renew their certification "without requiring the completion of a written examination."

The law prohibits the participation of any employee of a municipal ambulance service in cities with a population over one million.

The law has a "sunset clause" and will be repealed July 1st 2006. As of June 30, 2006 we will not accept any further applications to participate in the pilot program. Participants already registered in the program will be allowed to complete the requirements and renew their current certification.

What are the Benefits of Renewing through Continuing Education?

1. Retention of members/employees.

It is hoped that participants will find it easier and more convenient to renew their certification by participating in on-going continuing education activities. Providers, who might not renew their certification if they are required to take a written certification exam, may decide to maintain their certification through continuing education.

2. Variety of learning experiences

Refresher courses are designed to review the core content of the original training program. Although it is essential to review the core material, the refresher course does not expand on the core knowledge, nor does it introduce new or updated material.

A well balanced continuing education program will not only periodically review the core content, it allows participants to take part in a variety of learning activities which expand on the original core material, provides updates and introduces new material. It allows participants to use a variety of learning experiences such as seminars, workshops, journal clubs, interactive CD's, web-based programs and other learning activities.

4. Its more interesting

After taking the same refresher course for the third or forth time its difficult to find interest or enthusiasm in actively participating in another one. It can be much more interesting if you can vary your activities and are able to tailor your learning experience to your interest and needs. If you're interested you participate more actively and gain more from the experience.

5. Greater choices and options

Having the choice of when, where and what kind of learning activities you participate in may make it easier to arrange these activities around your schedule and life style. With the option of so many types and variety of continuing education activities you can design a program that meets your specific needs.

6. Designed to meet individual/agency needs

Continuing education programs can be developed to meet the specific needs of the agency and its members. They can be designed to reflect the needs identified through quality assurance/quality improvement programs. Needs-assessments can identify specific performance areas (clinical and non-clinical) that could be improved with training. Participants can identify what topics they are interested in.

How does an Agency apply?

Agencies interested in participating in the Pilot Recertification Program need to file an "Agency Registration Form" (DOH-4227).(PDF, 115KB, 2pg.)

The Agency must make a commitment to support the program. It must agree to assist its members to achieve success by providing opportunities for in-service training, drills, audiovisuals, magazines, books, journal clubs, and/or other continuing education activities. The Agency must agree to maintain records of the continuing education activities of its members.

Agencies may wish to work together and consolidate their efforts to provide a quality continuing education program. They may wish to affiliate with a local college, course sponsor or their county EMS coordinator's office. These efforts are encouraged. If this option is chosen a written agreement between the agencies must be filed with the Bureau of EMS outlining specific details on who will be responsible for each piece of the program and where the records will be kept. Each agency must maintain its own "agency" file with a listing of the agency's participants and their progress in the program. This file must be kept up to date and accurate regardless of any other written agreements as mentioned above. Individual participant files may be kept at a central location when multiple agencies or a course sponsor collaborates.

The Agency's Medical Director must agree to support the pilot program. The Medical Director should assist with in-service training and other continuing education activities. For ALS providers, the Medical Director must verify that they have maintained appropriate skill proficiency. They may do this by direct observation, through quality improvement activities, or formal skills evaluation.

Agency Responsibilities

The pilot recertification program is agency based. This means that the agency must not only apply to be in the program, but it must also assist its members within the program. An individual can not recertify in the program unless they belong to an agency that is participating in the program. Agencies must abide by certain requirements of the program such as, but not limited to:

  • Maintaining pilot recertification program records for a minimum of 7 years.
  • Complying with all deadline dates outlined within the program. A common problem has been with delays in agencies and providers obtaining the required signatures and thereby submitting renewal paperwork late.
  • Assuring that all agency and participant files are kept up to date. Files found to be more than 30 days out of date will be in violation of the program.
  • Assuring that the contents of all files are kept in chronological order.
  • Assuring that all program records must be made available within 24 hours for auditing purposes by the Bureau of EMS and/or the New York State Office of the State Comptroller.
  • Assuring that all forms are submitted within the required time periods.
  • Agency reimbursement vouchers must be submitted to the Bureau of EMS within 60 days of the participant receiving their new certification card.
  • Abiding by all regulations and policies set-forth by the Bureau of EMS.

Affiliation Agreements

If an agency decides to consolidate resources among other agencies, a course sponsor, EMS coordinator's office or a private company, an affiliation agreement (contract) must be developed and kept in the agency file as well as a copy sent to DOH BEMS Central Office in Troy. The affiliation agreement will differ from one agency to another. However, following is a list of items, which should be contained within the agreement:

  • The location of all participant files. The agency is responsible to have participant files at the agencies location. However, they may be kept at the affiliate's location as long as this is stated in the affiliation agreement and access can be guaranteed within the required 24 hours.
  • Specifically states the responsibilities of the affiliate, the agency and participants.
  • Monthly participant summary reports must be submitted to the agency from the affiliate. These reports must show the most updated information on each participant in the program including participant attendance records, copies of CME content material, copies of all current certification and other pertinent cards, etc.
  • Financial responsibilities. The agreement must state who will be vouchering the Bureau of EMS and when. Any other financial agreements between the affiliate and the agency.
  • If participant skills will be verified by the affiliate, how and when will they be verified.
  • What educational content the affiliate agrees to provide to the agency and the program participants. Many course sponsors provide only the core content portion of the program.
  • How participant attendance will be verified by the affiliate. A verifiable sign-in sheet should be used for attendance purposes.
  • Names, locations, telephone numbers and address of all responsible parties from the agency and the affiliate.

Who can participate?

EMTs, EMT-Intermediates, EMT-Critical Care Technicians and Paramedics may participate in the Pilot Program if they are currently certified, actively providing prehospital care at the certification level they are seeking and are current active members or employees of an agency already registered in the pilot program. The agency must be authorized to provide the level of care for which the participant is seeking recertification. For example, a Paramedic can not recertify through a registered agency that only provides a level of care up to the Intermediate level.

Participation is voluntary. An EMS Agency can not require a member/employee to participate in the pilot program. Participants may withdraw from the program at any time.

Participants must be "in continuous practice." To participate in the pilot program the EMT/AEMT must be currently certified and actively providing prehospital care. Their application to renew their certification must be postmarked at least 45 days before, but no more than 9 months prior to their current certification expiration date. Participants cannot allow their certification to expire during the program. Expired certifications are not eligible for renewal in this program. If your certification expires, you will need to enroll in a standard refresher course.

Each participant must complete a "Participant Registration Form"(PDF, 17KB, 2pg.). This form must be submitted prior to or along with the participant's renewal paperwork.

What does a participant have to do to renew their certification?

In order to recertify you must be participating in the program. When you recertify, you must submit the appropriate New York State Pilot Recertification Form. You can no longer submit a National Registry Recertification form instead of a NYS approved form. National Registry forms submitted instead of approved NYS forms, will be denied for recertification. Please make sure you have the most recent form before you submit your paperwork. The forms are available on our web site in a downloadable and fillinable Adobe Acrobat format.

To renew certification, an EMT/AEMT must complete at least 72 hours of " appropriate continuing education" that includes:

  1. Refresher Training (review of core content)
  2. CPR Certification
  3. ACLS Certification for paramedics
  4. Additional EMS related continuing education
  5. Verification of skill maintenance

Refresher Training is a review of the core content of the initial training program. Copies of the appropriate curriculum to be used can be found on the Bureau of EMS's web site. While it is ideal for the purpose of remediation, it is not intended to expand on knowledge or skills beyond entry-level training. For each level of provider there are specific minimum requirements for refresher training. A New York State Certified Instructor Coordinator (CIC) must oversee all "Core Refresher Training" activity. The CIC bears sole responsibility for the content of these sessions. If the CIC is unable to be present for a core content CME, the CIC must review the content of the CME and have proof that the participant attended the CME, before the CIC can approve the CME for use as core content.

CPR certification must be at the professional provider level and must be current. It should be equivalent to the American Heart Association's Basic Life Support for Healthcare Providers or the American Red Cross: CPR for the Professional Rescuer. CPR courses must meet the current AHA/ARC/NSC guidelines and must include:

  • Adult 1 & 2 Rescuer CPR
  • Adult Obstructed Airway
  • Child 1 & 2 Rescuer CPR
  • Child Obstructed Airway
  • Infant CPR
  • Infant Obstructed Airway

Paramedics must provide verification of current Advanced Cardiac Life Support certification. If CPR or ACLS course completion cards are submitted at the time of recertification, a photocopy of both the front and back of the card must be submitted. No original cards will be accepted, only photo copies.

Additional continuing education in varying EMS related topics provides the opportunity to keep up with the ever-changing field of emergency medicine and prehospital care. Attending lectures, EMS conferences, nationally recognized continuing education courses, approved self-study, journal clubs, call audits/case reviews, "grand rounds," and other directed studies allows the participant to keep up with these rapid changes.

Verification of proficiency in skills must be achieved by direct observation, quality assurance and quality improvement programs, or practical skills examination. This could be accomplished as part of the "Core Refresher Training" module(s) utilizing DOH Practical Skill Evaluation forms. Whichever method is used, there must be documentation within the agency file on precisely how the skills will be verified. For example, if quality assurance is used through documentation on a prehospital care report, this must be stated in the file. If direct observation is used there must be documentation stating how, where and by whom the skills were verified.

What are the different continuing education requirements for each provider level?

The EMT, EMT-I, EMT-CC and Paramedic each have specific requirements for completing the 72 hours of continuing education.

EMT-Basic

  • 24 hours of Refresher Training (review of core content)
    • Preparatory (1)
    • Airway (2)
    • Patient Assessment (3)
    • Medical/Behavioral (8)
      • General Pharmacology/Respiratory/Cardiac (4)
      • Diabetes/Altered Mental Status/Allergies (2)
      • Poisoning/Environmental/Behavioral (2)
    • Trauma (4)
    • Obstetrics/Gynecology (2)
    • Infants and Children (2)
    • Elective (2)
  • 48 hours of additional continuing education requirements, which must include:
    • Geriatrics (minimum of 3 hours)
    • WMD/Terrorism (minimum of 3 hours)

EMT-Intermediate

  • 34 hours of Refresher Training (review of core content)
  • 24 hours of EMT-Basic Refresher Training
    • Preparatory (1)
    • Airway (2)
    • Patient Assessment (3)
    • Medical/Behavioral (8)
      • General Pharmacology/Respiratory/Cardiac (4)
      • Diabetes/Altered Mental Status/Allergies (2)
      • Poisoning/Environmental/Behavioral (2)
    • Trauma (4)
    • Obstetrics/Gynecology (2)
    • Infants and Children (2)
    • Elective (2)
  • 10 hours of EMT-Intermediate Refresher Training (review of core content)
    • Preparatory (2)
    • Advanced Airway Management/Ventilation (3)
    • Patient Assessment (2)
    • Trauma (3)
  • 38 hours of additional continuing education, which must include:
    • Geriatrics (minimum of 3 hours)
    • WMD/Terrorism (minimum of 3 hours)

EMT-Critical Care Technician

  • 36 hours of Refresher Training (review of core content)
    • Preparatory (5)
    • Airway Management (5),
    • Trauma (8)
    • Medical (12)
      • Respiratory & Cardiac Emergencies (5)
      • Allergic Reactions and Poisoning (2)
      • Neurological and Abdominal Emergencies (2)
      • Environmental/Behavioral/Gynecological (3)
    • Special Considerations (5)
      • Obstetric Emergencies (2)
      • Neonatology (1)
      • Pediatrics (2)
    • Operations (1)
  • 36 hours of additional continuing education, which must include:
    • Geriatrics (minimum of 3 hours)
    • WMD/Terrorism (minimum of 3 hours)

Paramedic

  • 48 hours of Refresher Training (review of core content)
    • Preparatory (6)
    • Airway Management & Ventilation (6)
    • Trauma (10)
    • Medical (18)
      • Pulmonary and Cardiology (6)
      • Neurology/Endocrinology/Allergies & Anaphylaxis (3)
      • Gatroentaerology/Renal & Urology/Toxicology/Hematology (3)
      • Environmental Conditions/Infectious & Comm. Diseases/Behavioral (3)
      • Gynecology and Obstetrics (3)
    • Special Considerations (6)
      • Neonatology and Pediatrics (3)
      • Abuse and Assault (1)
      • Patients w/Special Challenges and Acute Interventions for Chronic Care Patients (2)
    • Operations (2)
  • 24 hours of additional continuing education activities, which must include:
    • Geriatrics (minimum of 3 hours)
    • WMD/Terrorism (minimum of 3 hours)

What type of continuing education is accepted?

Continuing education programs should include many different learning activities. Topics must be directly relevant to EMS and/or prehospital care. You must be able to document attendance, participation and content.

Continuing education credit can only be received for time the candidate actually participates in the activity. As an example if an 8-hour course ends 2 hours early, the participant can only receive credit for 6 hours.

A maximum of 12 hours for "core content" and 24 hours for additional CME hours may be credited for self-study activities through documented continuing education via publications, video and/or Internet training.

A maximum of 8 hours may be credited for teaching CPR courses and this can only be used once for each recertification period.

A CIC who teaches an original or recertification course can claim the maximum hours for the "core content" area only.

National continuing education programs like PHTLS, BTLS, PALS, ACLS, AMLS, SCOPE, PEPP, GEMS, etc. may be used towards "core content" areas or for additional CME areas. A breakdown of each course and how you should record the hours on your recertification form can be found on our web site. If a course is not listed in that document please contact our office for guidance.

A maximum of 12 hours may be credited for any one specific topic.

Example of Self Study Activities:

  • Magazine articles (JEMS, Emergency Medical Services)
  • Videos (Pulse/EMU, FETN, etc)
  • Interactive CD
  • Web-based courses

Example of Other Continuing Education Activities

  • Journal Clubs
  • Call Review/Audits, Grand Rounds
  • Agency Drills or in-service training
  • Lectures, Seminars, EMS Conferences
  • Nationally recognized continuing education programs
    • Pediatric Courses (PALS/APLS, PPCC, TRIPP, PEPP, SCOPE)
    • Trauma Courses (PHTLS, BTLS, ATLS)
    • Adult and Geriatric Medical Emergencies (AMLS or GEMS)
    • Ambulance Driving (CEVO, EVOC, Defensive Driving)
    • OSHA required training
    • HAZMAT
  • Directed Studies
    • Literature review
    • Research
  • Practicum
    • Hospital Clinical Performance Evaluations
  • Skill Workshops

Continuing education credit can only be received for time the candidate actually participates in the activity. As an example if an 8-hour course ends 2 hours early, the participant can only receive credit for 6 hours.

How will the Pilot Recertification Program be Evaluated?

As a pilot study, the program must be evaluated to determine the impact of the program on the quality of patient care and the effectiveness of the program in retaining EMTs/AEMTs.

Surveys and Questionnaires

Participants

Participants will be surveyed to determine how satisfied they are with the program. Was it easier and more convenient than attending traditional refresher programs? Do they feel they learned more/less? Did it effect their decision to renew their certification?

Agency Chief Officers

The leadership of participating EMS Agencies may also be surveyed to determine how satisfied they are with the program. Do they feel it is helping them to keep more EMT/AEMT on-line? Have they noticed any difference in providers who are participating in the program versus those who are not? Are they having difficulty providing in-service training, drills and other continuing education activities?

Agency Medical Directors

Medical Directors may be surveyed on how satisfied they are with the program. Do they feel that the continuing education being offered is adequate to maintain or improved the quality of patient care? Have they noticed any difference in the care provided by participants versus non-participants?

Receiving Hospitals

Emergency Department staff may be interviewed to determine their satisfaction with the program. Are they aware of the program? Is it integrated with their quality improvement activities? Do they provide continuing education for EMS providers? Have they noticed greater participation at call reviews, EMS grand rounds, lecture series, etc.?

REMAC

The Department will work with the local REMAC to determine their satisfaction with the program. Is there an impact on the quality of patient care? Have patient care complaints or protocol violations increased/decreased? Is there greater participation by agencies and providers in quality improvement activities?

Random Audits

The Department or its designee will conduct audits of randomly selected participants to review and verify their participation in continuing education activities. Attendance records and other documentation will be reviewed for each item listed on the participant's renewal form. Some interviews may be scheduled with participants and/or others involved in the continuing education program.

The Department or its designee may sit-in on (audit) some continuing education programs.

Random Testing

The Department or its designee may test randomly selected participants. Testing may be in the form of quizzes or written examination and/or skills examinations. These tests will be used to compare the knowledge and performance of participants in the pilot program with non-participants. The results of the test for any specific individual will remain confidential and will not effect the certification of the individual.

Comparison: Participants/Non-Participants

A sample group of Participants versus Non-Participants will be used to compare percentages of patient care complaints, protocol violations and disciplinary actions. All information on specific individuals and agencies will remain confidential.

Is there funding available for the pilot program?

Currently funding is available for the refresher-training portion of the Pilot Recertification Program. Reimbursement is available to course sponsors or agencies for candidates who renew their certification through the pilot program.

Reimbursement Rate

  • EMT-Basic $300.00
  • EMT-Intermediate $375.00
  • EMT-Critical Care $400.00
  • Paramedic $500.00

Reimbursements are paid to a Course Sponsor or Agency

Either the Course Sponsor or the EMS Agency can apply for reimbursement. Course Sponsors may offer special refresher courses that cover the specific core-content material required for the pilot program. If the candidate enrolls in and attends a Pilot Core Refresher course to meet the continuing education requirements, the course sponsor can seek state reimbursement. The candidate can only receive credit for class/lab sessions he/she attends. No credit can be awarded for challenged or waived sessions. The course sponsor may voucher for state reimbursement upon the candidates completion of the core-content material. The course sponsor may not charge tuition to the student or agency if they plan to receive this state reimbursement.

If an Agency pays for the candidate's refresher-continuing education activities, the Agency may voucher the state for reimbursement of those expenses up to the maximum rate listed above. The agency may voucher for reimbursement after the candidate has achieved re-certification through the pilot program. The voucher must be submitted within 60 days of the participant receiving their new certification card.

All reimbursements must be requested through the use of the State of New York Standard Voucher (Form AC 92). A detailed list of providers who you are seeking reimbursement for must accompany the voucher. This list must include the provider's name, certification number, and the certification level they have recertified through the program. For detailed instructions on how to complete the voucher, please check our web site or contact our office.

Instructors and Instructor Candidates

Certified Lab Instructors, Certified Instructor Coordinators and instructor candidates are eligible to participate in the Pilot Recertification Program. In order to become a certified instructor, take an instructor course or recertify your current instructor certification, you must have a NYS Written Examination grade within the last three years or since your last instructor recertification. If you do not have this grade and you are participating in the Pilot Recertification Program, you need to contact our office at 1-800-628-0193. When you call this number, advise us that you need to take an exam for an Instructor's Score because you are in the pilot program. Our staff will schedule you for a written exam. You must contact us at least 6 weeks prior to the date of the exam you wish to be scheduled for. The certification level of the exam you need to take depends on what type of courses you wish to teach. For example, if you are a Paramedic and you wish to teach only CFR or EMT courses, you only need to take the EMT written exam or if you wish you may take the Paramedic written exam. If you choose to receive on-site, scoring you will be responsible for the appropriate fees for that service. You must obtain an 85% or greater on the written exam for instructor certification. Instructors are not required to take a Practical Skills Examination when recertifying through this pilot program.

Other Frequently Asked Questions

Does participating in the pilot program mean I never have to take an examination?

No, there will be examinations, quizzes, and practical evaluations as part of your continuing education activities. Participants in the pilot program must actively participate in all of the continuing education requirements, including any testing activities. The continuing education program may use pre and post quizzes to measure what learning has taken place. Some programs will use examinations at the end of the program to determine if the participants need any further remediation. Some programs may use games like "Jeopardy" or similar activities to "test" what the participants know. Practical evaluation may include the observation of group practice activities or a more formal skill evaluation station.

Participants are not required to take the State written certification examination.

The biggest difference is that the quizzes, exams and practical evaluation in continuing education programs are designed to let the participant know their strengths and weaknesses.

National Registry is a two-year certification, is the pilot program only for two-years?

No, certification in New York is issued for a three-year period.

Does everyone in my agency have to attend the same continuing education activities?

No, each individual can use a different means of completing the requirements. For example, some may attend a full refresher course (to apply towards the core content only), some may take a class here and there, some will have a lot of continuing education activities already and some will be starting from scratch. Each person will be treated as an individual. The idea is to open up more options and choices in the way your members re-certify.

Do I have to take a Refresher Course to meet the requirements of the "Refresher Training" section?

No, there are many ways to meet the requirements of Section IA: Refresher Training. The continuing education activities to review the core content material must be coordinated by a Certified Instructor Coordinator (CIC). This can be done through in-service training or drills as long as the sessions are coordinated by a CIC.

Many Course Sponsors are offering special courses just to meet the "refresher training" requirements of the pilot program. Some Sponsors are allowing participants to attend specific sessions of an on-going refresher course.

I have attended EMS conferences and other continuing education activities already, can any of my previous activities count towards the pilot program?

Yes, all continuing education activity you have participated in since the last time you certified is eligible credit for the pilot recert program. You must be able to document your attendance and provide information on the topic, date, time and instructor.

I am already a Nationally Registered EMT/AEMT can I renew my New York State certification at the same time I reregister with NREMT?

Yes, if you are a registered participant in the pilot program and registered with the National Registry of Emergency Medical Technicians (NREMT), you can renew your New York State certification. However, you must submit the appropriate NYS approved form for recertification. You can not send in you National Registry renewal instead of a NYS form.

Do I get extra time added to my new card if I mail my renewal application in more than nine months before my certification expires?

No. If you mail in your recertification packet with nine or less months left on your certification, your new expiration date will be based on your old expiration date.

What if I take a challenge exam to waive attendance in some refresher course sessions, do I get credit from them in the pilot program?

No, you can only receive continuing education/refresher credits for the classes you actually participate in.

If I take a full refresher course without taking the state exam with the class, will that meet all the requirements for the Pilot Recertification?

No. You can take a complete refresher course but you may only use the hours to fulfill the "refresher training" or "Core Content" requirements for the level at which you wish to certify.

They Must Be Used Starting January 1st, 2005.

Who should I contact if I have any other questions and Where do I send all paperwork and communication for the program?

Bureau of Emergency Medical Services
New York State Department of Health
433 River Street, Suite 303
Troy, New York 12180
Phone: (518) 402-0996
Fax: (518) 402-0985
Email: ems@health.state.ny.us

Approved Forms

These forms (dated 7/03) replace any previous version of the forms.

They Must Be Used Starting January 1st, 2005.